High-Dose Intravenous Epoprostenol and Adjunct Therapies for Refractory Raynaud’s Phenomenon Associated with Anti-Jo-1 Antibodies: A Case Report
Bibliographic record
Abstract
This case report highlights the use of intravenous high-dose Epoprostenol for managing severe digital ischemia in a patient diagnosed with antisynthetase syndrome (ASyS) exhibiting anti-Jo1 antibodies positivity, emphasizing its vasodilatory benefits and challenges with tolerability at higher doses. A multi-modal treatment strategy, including calcium channel blockers, phosphodiesterase inhibitors, hyperbaric oxygen therapy, and prostacyclin analogs, was critical for optimizing outcomes in refractory Raynaud’s phenomenon. This case underscores the importance of individualized treatment regimens and the need for ongoing monitoring and adjustments to balance therapeutic efficacy with patient safety. The report contributes to the limited literature on the management of severe digital ischemia in ASyS and emphasizes the potential role of adjunct therapies in improving patient outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".